Individual provider Active NPI

Laura Marie Brixius

  • Physician Assistant
  • Minnetonka, MN
National Provider Identifier
1821720178
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
14001 Ridgedale Dr Ste 100
Minnetonka, MN 55305-1781
Phone
(952) 473-0211
NPI assigned
Jun 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MN Primary

Addresses

Primary practice location

14001 Ridgedale Dr Ste 100
Minnetonka, MN 55305-1781

Mailing address

14001 Ridgedale Dr Ste 100
Minnetonka, MN 55305-1781
Phone (952) 473-0211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wayzata Children'S Clinic P.a. CurrentSince Jul 11, 2011 Accepting new patients
Consulting Radiologists, LTD Past Accepting new patients
Ridgeview Medical Center PastSince Feb 4, 2024 Accepting new patients

Locations

111 Hundertmark Rd
Ste 420
Chaska, MN 55318
Phone (952) 448-3847

916 Saint Peter Ave E
Ste 120
Delano, MN 55328
Phone (763) 230-2780

14001 Ridgedale Dr
Ste 100
Minnetonka, MN 55305
Phone (952) 473-0211

4695 Shoreline Dr
Ste A
Spring Park, MN 55384
Phone (952) 495-8910

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1821720178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14001 RIDGEDALE DR STE 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051781",
            "telephone_number": "952-473-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14001 RIDGEDALE DR STE 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051781",
            "telephone_number": "952-473-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIXIUS",
        "first_name": "LAURA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.